If you survey the American public on efforts to restrict the number of hours medical residents can work without sleep or time off, there’s overwhelming support for new rules and regulations. The relationship between lack of sleep and the increased likelihood of impaired judgment and medical errors seems like a no-brainer to most patients. The bigger challenge is to convince residents themselves – and, perhaps even more, those who teach new physicians – that work hour limits make sense...and can be implemented without compromising continuity of care or interfering with education and training. Still, a growing number of residency program leaders are discovering that the only way to move this debate forward is to dig in and start innovating and doing things differently.

David Sweet and James Whiting are two such program directors who will be joining WIHI host Madge Kaplan on January 27 to describe what residency training can look like in systems grounded in patient safety, greater teamwork, better handoffs, increased supervision, and educational redesign. The changes at Summa Health System (16-hour limits are the norm for all residents) and Maine Medical Center are noteworthy; they join a growing number of residency programs not just doing the bare minimum to comply with Accreditation Council for Graduate Medical Education (ACGME) rules, but seeking to create new and better models of care.

Christopher Landrigan’s research on sleep deprivation and patient safety, along with Don Goldmann’s knowledge of hospital improvement and the goals of residency training, will deepen the conversation and round out what is sure to be a rich discussion. Both Drs. Landrigan and Goldmann appreciate the challenges residency programs now face to institute critical changes, but reform also opens up all sorts of possibilities. We hope you’ll join us on the next WIHI. To enroll, please click here.

1 comment:

Perhaps we should ask residents if they would consider taking an intercontinental flight in a plane whose pilot had just filed 16 consecutive hours; or take a Greyhound bus whose driver had already driven 16 hours and was about to embark in a 6 hours trip!